Home enteral nutrition in children: a 14-year multicenter survey.

Background/Objectives: The practice of home enteral nutrition (HEN) represents a relevant aspect of the clinical management of both malnourished children and well-nourished children unable to be fed using an oral diet. The aim of this study was to estimate in an Italian paediatric population over a 14-year period (1996-2009), the clinical relevance and results over time of HEN activity. Subjects/methods: HEN-computerized database and medical/dietetic charts were evaluated for patients aged at start of HEN 1 month. Results: During the study period, we recorded 757 HEN programs. HEN began at a median age of 2 years for a median duration of 8.1 months. The complication rate was 14.8%. In the second period of the survey (2003-2009), the main changes concerned the underlying diseases requiring HEN, choice of formula feeding and access route. In 2009, the estimated overall prevalence of HEN was 3.47 and the incidence 2.45 per 100 000 inhabitants from 0 to 18 years of age. Conclusions: The epidemiological data of this study demonstrate that HEN concerns a growing number of Italian children and families. Some aspects of HEN clinical management should be modified to reach the recommended standards. © 2013 Macmillan Publishers Limited

Modello regionale di presa in carico del bambino sovrappeso e obeso

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Tests on OPERA RPCs

OPERA is an experiment for the observation of nu(tau) into nu(tau) oscillations through tau appearance using a 730 km baseline nu(mu) beam from CERN to Gran Sasso underground laboratory. The magnet yokes of the two muon spectrometers are instrumented with high resistivity bakelite RPCs operated in streamer mode. The RPC installation ended in March 2005. As the detectors will be inaccessible during the operation, we performed long term operation as well as quality control tests. The results of the long term and of the Quality Control tests are presented

Natural history of intestinal failure, investigated through a national network-based approach

Objectives: Intestinal failure (IF) is a condition whose treatment requires advanced knowledge and techniques and a multidisciplinary approach. Intestinal failure is the endpoint of many intestinal diseases and may result in full recovery, in life-long parenteral nutrition, or in the death of the child. The aim of this study was to evaluate the natural history of IF in children using a national network of resources. Methods: Italian centers of pediatric gastroenterology merged in a national network, developing a collaborative management approach for children with IF. A consensus definition of IF was achieved. A database was set up to investigate the cause, epidemiologic factors, and natural history of IF. Results: One hundred nine children were enrolled in 5 years. The cause of IF was: short bowel syndrome (n = 48), disorders of motility (n = 16), structural enterocyte defects (n = 14), multiple food intolerance (n = 10), autoimmune enteropathy (n = 7), and others or unknown (n = 14). The eventual outcome was closely related to the primary cause, ranging from full and permanent intestinal sufficiency in children with multiple food intolerance to high death rate or total dependance upon parenteral nutrition in those with structural enterocyte defects. Intermediate outcomes were observed for the other causes. Four children received intestinal transplantation. Conclusions: The network approach for IF provides an effective model to optimize resources and to investigate prospectively the natural history of IF. Based on the work on this series, a European network for IF could be an effective model for fulfilling the diagnostic and management needs, including intestinal transplantation

OPERA resistive plate chambers underground test results

The OPERA experiment [1] will study nu(mu)->nu(tau) oscillations through tau appearance on the 732 Km long CERN to Gran Sasso baseline. The magnet yokes of the two muon spectrometers are instrumented with 44 layers of high resistivity bakelite Resistive Plate Chambers (RPCs) operated in streamer mode. Each layer covers about 70 m(2). Four RPC planes were instrumented and the first tests were performed confirming a good behaviour of the installed RPCs in terms of intrinsic noise and operating currents. The measured noise maps agree with those obtained in the extensive quality tests performed at surface. Counting rates are below 20 Hz/m(2). Single and multiple cosmic muon tracks were also reconstructed. The estimated efficiency is close to the geometrical limit and the very first measurements of the absolute and differential muon flux are in agreement with expectations